Value of color doppler ultrasound: parameters for proximal vascular access patency

Sousa, M; Germano, A; Gomes, A; Rocha, R; Marinho, R; Fragoso, M; Pignatelli, N; Nunes, V

http://hdl.handle.net/10400.10/1147

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Abstract(s)

Background: Color Doppler Ultrasound (CDU) is essential for vascular mapping in vascular access planning/creation. The aims of this study was to evaluate which anatomical and physiological variables of the artery and the vein, measured by CDU, were associated with higher patency at one year follow-up in brachiocephalic (BC) and brachiobasilic (BB) primary AV fistula (AVF). Materials and Methods: Retrospective observational analysis of patients admitted at our institution between January 2011 and June 2013 for native proximal AVF creation after CDU vascular mapping. Results: We analyzed 61 patients, mean age of 66,1±6,8; 26 female; 43 BC and 18 BB access, mean follow up 37,9 months, 69% of patency at one year follow up. Brachial artery and venous diameter, Resistance Index and venous distensibility show no differences between groups. Brachial Artery flow was higher in the 1 year patency group (0,160l/min±0,11 vs 0,19l/min± 0,06; t=2,37;df=59; p<0,05) as well as the peak systolic velocity (78,77m/s±23,2 vs 65,47m/s±18,47; t=2,09;df=59; p<0,05) and distance between the artery and the vein (a-v distance) (31,73mm ±11,9 vs 17,75mm ±8,61; t=3,70;df=59; p<0,001). The presence of comorbidities as diabetes and arterial hypertension were higher in the non-patency group (p<0,05). Logistic regression performed confirmed positive association between brachial artery flow, peak systolic velocity and a-v distance and AVF patency (p<0,001; Exp(B)꞊0,265). Conclusions: Of the CDU variables measured, in our population, higher brachial artery flow, higher peak systolic velocity of brachial artery and higher distance between artery and vein influenced the one year patency.